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Weightism: The newest discrimination in America?

Few would dispute that curbing rising rates of obesity is one of the greatest public health challenges of the 21st Century, yet as a nation, we grapple with how to talk about being fat. The Centers for Disease Control and Prevention even dances around the subject by labeling overweight kids "at risk for overweight" and obese kids "overweight."

One might argue that labeling any kids or adults is wrong, but you can’t solve the problem unless you name it and quantify it. Well, we’ve quantified it. Roughly one-third of adults are obese and two-thirds are overweight.

ObesitySo now, we have to do something about this grossly expensive epidemic. Some employers facing ballooning health costs have taken punitive approaches to push their workers to lose weight. But arms flew up aghast when Chicago’s police chief dared to say that all officers must pass a physical fitness test. The police department already has a voluntary program that provides a $250 bonus to the cops that pass. Voluntary, clearly didn’t work

Some obesity experts say these punitive approaches to reduce obesity won’t work, and in fact, they are discriminating. Some have coined this "weightism."

Researchers at Yale University published a paper last month in the International Journal of Obesity saying discrimination based on weight is as much of a problem in American society as discrimination based on race or gender, especially for women and individuals with a Body Mass Index of 35 or higher (a 200 pound 5’4" person has a BMI of 35).

Many contributing factors to obesity are beyond individual control and simply suggesting that people exercise more and eat less probably won’t work, especially if you live in a neighborhood without safe streets and parks and no healthy food. But some behaviors are within our control, and progress cannot be made if political correctness overtakes frank discussions.

I asked one of the Yale study’s lead authors, Rebecca Puhl, about the study, discrimination and possible solutions to the obesity epidemic. Here are her answers:

The study was based on data from 1995-1996. The number of overweight and obese people has grown substantially since then. Thus, would you expect your conclusions of the percent of people who experience discrimination based on their weight to be greater?

We actually controlled for increasing obesity rates in our statistical analysis, so we can confidently conclude that the findings do not reflect increases in obesity, but rather reflect increases in reported experiences of weight discrimination.

Isn’t discrimination based on weight fundamentally different discrimination based on sex, race or disability? Why do you or don’t you agree?

Because people often assume that body weight is "a choice", they feel that it shouldn’t be considered a legitimate form of stigma or discrimination. This is wrong. The causes of obesity are very complex, and to assume that obesity is a choice significantly oversimplies the notion that significant weight loss can be sustained over time. Only a small percentage of people can reach this goal. A large body of science using randomized clinical control trials show poor long-term results in the ability to sustain significant weight loss over time – even with intensive and expensive treatment options. This had led to a greater appreciation of the role that biology plays in regulating body weight, and in the difficulty of sustaining weight loss over time. So, we need to challenge the common assumption that body weight is simply an issue of willpower, and consider the science about the causes and treatment of obesity. I think we also need to question whether a person needs to justify a genetic or biological predisposition for their obesity in order to receive the basic human right of equality. The answer to that is no.

Do you believe discriminating against obese people is wrong? Why? The World Health Organization currently will not hire people who smoke. What if they said they would not hire people with a BMI of 30 (5’4" woman who weights 180 pounds)? Is this the same or different?

Discriminating against an individual because of his or her weight is certainly wrong. It is also important to recognize that BMI is not necessarily an automatic or accurate indicator of health. There are many individuals who are not overweight who are very unhealthy (who, for example, may have high blood pressure or cholesterol), and similarly there are people who are overweight who are in good health and whose blood pressure and cholesterol are in the normal range.

Currently, many large employers are experimenting with wellness programs to help their employees adopt healthy behaviors and thereby reduce health costs. Obese and overweight people and smokers are the primary target of such plans. Is this discrimination?

Rather than imposing penalties on individuals who have a certain BMI or who smoke, which can become discriminatory, a better way for companies to address increasing costs associated with obesity or smoking is to initiate and support social changes that can help change the conditions that create obesity in the first place (such as increasing access of affordable healthy foods, providing opportunities for physical activity, and promoting healthy work environments where it is easy for employees to be healthy.Wellness programs that reward people for making healthy lifestyle changes through improved eating habits or physical activity is much more appropriate and doesn’t discriminate people based on weight. Poor diet and physical inactivity are hurting everybody ñ not just those who are overweight. So incentive programs that reward healthy behaviors offer a much broader umbrella under which people can be supported to become healthier, regardless of their body weight.

While significant contributing factors to obesity, such as environment and genetics, are not behavioral. Many other factors are, thus changing behaviors and social norms is a must to curb rates of obesity. Given the difficulty in changing behaviors but the incredible expense associated with obesity, what solutions do you propose to curb obesity rates that do not "discriminate" against this population?

Currently, our culture is taking a "personal responsibility" approach to try to reduce obesity. We have a billion dollar diet industry that is based on this premise, and thousands of diet books, pills, and plans. But obesity rates continue to rise, and this approach is clearly not working. We need to make major changes in our environment to make it easier for people to be healthy.(As I mentioned above, this can include increasing access and advertising of affordable healthy foods, providing opportunities for physical activity, and promoting healthy work environments where it is easy for employees to be healthy.)

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MattDr. Michael J HollisMaryellen SmithGEMSarah Arnquist Recent comment authors
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Matt
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Matt

There is also discrimination against people that are underweight or even just skinny. I am 5’10 and weigh 145 lbs. I eat healthy, about 3000 calories a day, and exercise 4 times a week with a little running and weight lifting. According the the BMI I am right where I need to be, not underweight whatsoever. Apparently to the rest of America though, I look anorexic. Society judges way too much. Being healthy is much more important than your weight. I look skinny to some, but in reality I am in tip top shape. My friends parents always want me… Read more »

Matt
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Matt

I agree with Dr. Michael J Hollis, although I wish overweight people would take more responsibility and not blame the media, fast food, and society.

Dr. Michael J Hollis
Guest

Why is a mandate for weight control problematic in an institution where physical fitness is an asset? Cops are crime-fighters. Crime-fighting is perceived as a rigorous activity involving apprehension and restraint. All better performed by a body acclimated to agility and strength. Easy to say, I suppose. Friends of mine in the policing industry would offer a more comprehensive rebuttal. “Being a cop is more than beating up bad guys and throwing people in jail,” one friend would say while reminding me, “We probably spend more time sitting around writing reports, waiting in municipal court houses, and negotiating disputes between… Read more »

Maryellen Smith
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Maryellen Smith

Peter is on the right track…good food is so expensive that it’s economically counter-intuitive not to eat fast and processed food. If you do want to eat well and healthily (which not everyone can afford) it becomes a lifestyle choice that is likely to require compromises in other areas of your life.
Yes, the system is against us. Our culture glamorizes thinness and bombards us with food advertising at the same time. How much more of a mixed message could there be?

Peter
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Peter

GEM, I don’t know of the specific reason why it’s so hard for you to control your weight but the system is against you because it’s cheaper to grow and ship calories than nutrition. Especially when they’re subsidized.

GEM
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GEM

As someone who has suffered from obesity for most of my life I feel torn when I read an article like this one and especially the posts. I like that the researcher’s points about issues of stigma and overweight/obesity and I feel sad when I read the posts. If losing weight were so easy then there wouldn’t be any fat people but clearly it’s not. Being overweight/obese is painful and hard. I’ve been on every diet there is starting at age 11 on weight watchers, with the usual story of losing and gaining. I recently had bariatric surgery and have… Read more »

Sarah Arnquist
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Sarah Arnquist

I’m not opposed to group pressure to reduce rates of obesity at all. It just seems to me we can’t even talk about the issues yet. I’m actually concerned that so-called “weightism” issues will impede meaningful and important discussion. For instance, something like half of parents with overweight children don’t realize they’re overweight. Well, someone’s gotta tell them and that shouldn’t be considered prejudicial. In elementary school, all the kids get vision and hearing screenings. Now they need BMI screenings and the results sent home to parents. I posted this article because I thought the researchers’ had an interesting point,… Read more »

Peter
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Peter

“According to Michael Pollan”
I assume tcoyote you’ve read his, “The Omnivore’s Dilema”? Another book of his is, “In Defense of Food”. These are must reads for anyone interested in knowing why we’re fat and why the present subsidized industrial food system is making us sick, not to mention the concentration camp methods we use to raise animals.

tcoyote
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tcoyote

Agree w/ R Baer. According to Michael Pollan, we’ve increased our per capita sugar intake by 25% since 1985 w/o increasing our physical activity. The fact that we are hardwired to seek carbohydrates genetically sets the stage for ruinous changes in our body weight. People who do not take steps to control their carb intake get trapped metabolically, and it becomes very difficult to reset the body. The explosion in obesity was not genetically based, however. It resulted from personal choices and dreadful dietary habits. Travel abroad to places like Italy or Spain where people love to eat, and smoke… Read more »

rbaer
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rbaer

Why not combine “personal responsibility” and environmental change? They are not mutually exclusive. Ms. Arnquist believes that there should be no form of group pressure with regards to being normalweight and leading a healthy lifestyle. I think that she is mistaken. Yes, group pressure is stupid and has the inherent tendency to escalate into discrimination. However, the same force makes people not only to mow their lawns, but also not to avoid neglecting and (at least publicly) hitting their children, to stop smoking when people are around, to listen to each other without yelling or fighting … if you take… Read more »